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Metabolic syndrome and kidney disease: a systematic review and meta-analysis.
Clin J Am Soc Nephrol 2011; 6(10):2364-73CJ

Abstract

BACKGROUND AND OBJECTIVES

Observational studies have reported an association between metabolic syndrome (MetS) and microalbuminuria or proteinuria and chronic kidney disease (CKD) with varying risk estimates. We aimed to systematically review the association between MetS, its components, and development of microalbuminuria or proteinuria and CKD. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS AND POPULATION: We searched MEDLINE (1966 to October 2010), SCOPUS, and the Web of Science for prospective cohort confidence interval (CI) studies that reported the development of microalbuminuria or proteinuria and/or CKD in participants with MetS. Risk estimates for eGFR <60 ml/min per 1.73 m(2) were extracted from individual studies and pooled using a random effects model. The results for proteinuria outcomes were not pooled because of the small number of studies.

RESULTS

Eleven studies (n = 30,146) were included. MetS was significantly associated with the development of eGFR <60 ml/min per 1.73 m(2) (odds ratio, 1.55; 95% CI, 1.34, 1.80). The strength of this association seemed to increase as the number of components of MetS increased (trend P value = 0.02). In patients with MetS, the odds ratios (95% CI) for development of eGFR <60 ml/min per 1.73 m(2) for individual components of MetS were: elevated blood pressure 1.61 (1.29, 2.01), elevated triglycerides 1.27 (1.11, 1.46), low HDL cholesterol 1.23 (1.12, 1.36), abdominal obesity 1.19 (1.05, 1.34), and impaired fasting glucose 1.14 (1.03, 1.26). Three studies reported an increased risk for development of microalbuminuria or overt proteinuria with MetS.

CONCLUSIONS

MetS and its components are associated with the development of eGFR <60 ml/min per 1.73 m(2) and microalbuminuria or overt proteinuria.

Authors+Show Affiliations

Department of Nephrology and Hypertension, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH 44195, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Review
Systematic Review

Language

eng

PubMed ID

21852664

Citation

Thomas, George, et al. "Metabolic Syndrome and Kidney Disease: a Systematic Review and Meta-analysis." Clinical Journal of the American Society of Nephrology : CJASN, vol. 6, no. 10, 2011, pp. 2364-73.
Thomas G, Sehgal AR, Kashyap SR, et al. Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clin J Am Soc Nephrol. 2011;6(10):2364-73.
Thomas, G., Sehgal, A. R., Kashyap, S. R., Srinivas, T. R., Kirwan, J. P., & Navaneethan, S. D. (2011). Metabolic syndrome and kidney disease: a systematic review and meta-analysis. Clinical Journal of the American Society of Nephrology : CJASN, 6(10), pp. 2364-73. doi:10.2215/CJN.02180311.
Thomas G, et al. Metabolic Syndrome and Kidney Disease: a Systematic Review and Meta-analysis. Clin J Am Soc Nephrol. 2011;6(10):2364-73. PubMed PMID: 21852664.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metabolic syndrome and kidney disease: a systematic review and meta-analysis. AU - Thomas,George, AU - Sehgal,Ashwini R, AU - Kashyap,Sangeeta R, AU - Srinivas,Titte R, AU - Kirwan,John P, AU - Navaneethan,Sankar D, Y1 - 2011/08/18/ PY - 2011/8/20/entrez PY - 2011/8/20/pubmed PY - 2012/2/9/medline SP - 2364 EP - 73 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 6 IS - 10 N2 - BACKGROUND AND OBJECTIVES: Observational studies have reported an association between metabolic syndrome (MetS) and microalbuminuria or proteinuria and chronic kidney disease (CKD) with varying risk estimates. We aimed to systematically review the association between MetS, its components, and development of microalbuminuria or proteinuria and CKD. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS AND POPULATION: We searched MEDLINE (1966 to October 2010), SCOPUS, and the Web of Science for prospective cohort confidence interval (CI) studies that reported the development of microalbuminuria or proteinuria and/or CKD in participants with MetS. Risk estimates for eGFR <60 ml/min per 1.73 m(2) were extracted from individual studies and pooled using a random effects model. The results for proteinuria outcomes were not pooled because of the small number of studies. RESULTS: Eleven studies (n = 30,146) were included. MetS was significantly associated with the development of eGFR <60 ml/min per 1.73 m(2) (odds ratio, 1.55; 95% CI, 1.34, 1.80). The strength of this association seemed to increase as the number of components of MetS increased (trend P value = 0.02). In patients with MetS, the odds ratios (95% CI) for development of eGFR <60 ml/min per 1.73 m(2) for individual components of MetS were: elevated blood pressure 1.61 (1.29, 2.01), elevated triglycerides 1.27 (1.11, 1.46), low HDL cholesterol 1.23 (1.12, 1.36), abdominal obesity 1.19 (1.05, 1.34), and impaired fasting glucose 1.14 (1.03, 1.26). Three studies reported an increased risk for development of microalbuminuria or overt proteinuria with MetS. CONCLUSIONS: MetS and its components are associated with the development of eGFR <60 ml/min per 1.73 m(2) and microalbuminuria or overt proteinuria. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/21852664/full_citation L2 - http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&amp;pmid=21852664 DB - PRIME DP - Unbound Medicine ER -